Baude Jérémy, Dendale Rémi, Cao Kim, Fourquet Alain, Kirova Youlia
Department of Radiation Oncology, Institut Curie, 75005 Paris, France.
UFR Santé, Versailles Saint-Quentin-en-Yvelines University, 78180 Saint Quentin-en-Yvelines, France.
Cancers (Basel). 2023 Sep 12;15(18):4515. doi: 10.3390/cancers15184515.
The management of cancer relapse in previously irradiated tissues is a challenging therapeutic issue. The aim of this work was to report our experience with breast reirradiation for locoregionally recurrent breast cancer.
All patients who underwent breast or chest wall in-field reirradiation at the Institut Curie, Paris, France, between 2003 and 2019, were identified. Efficacy outcomes and physician-reported toxicities were retrospectively assessed.
A total of 21,372 patients underwent breast irradiation in our institution. Of these, 28 received a second course of radiotherapy to the homolateral breast/chest wall. A total of 18 (64%) patients were treated with a curative intent, and 10 (36%) were treated for palliative purposes. Only one acute and one late grade 3 adverse events were reported. One patient with major cardiovascular risk factors died of myocardial infarction 13 months after left breast reirradiation. The 2-year LRFS, OS, DSS, PFS and MFS were 59%, 79%, 82%, 46% and 75%, respectively, in the whole cohort. The 2-year LRFS (72% vs. 31%, = 0.02), OS (94% vs. 50%, < 0.01), DSS (94% vs. 56%, < 0.01) and PFS (61% vs. 20%, = 0.02) differed significantly between patients treated with curative or palliative intent but not the MFS (78% vs. 69%, = 0.77). Among the patients, eight (29%) remained relapse-free 5 years after reirradiation.
Breast/chest wall reirradiation appears to be feasible with good disease control, especially in patients treated with a curative intent, and presents acceptable toxicity rates.
既往接受过放疗的组织中癌症复发的管理是一个具有挑战性的治疗问题。本研究的目的是报告我们对局部区域复发性乳腺癌进行乳房再放疗的经验。
确定2003年至2019年期间在法国巴黎居里研究所接受乳房或胸壁野内再放疗的所有患者。对疗效结果和医生报告的毒性进行回顾性评估。
我们机构共有21372例患者接受了乳房放疗。其中，28例接受了同侧乳房/胸壁的第二疗程放疗。共有18例（64%）患者接受了根治性治疗，10例（36%）患者接受了姑息性治疗。仅报告了1例急性和1例晚期3级不良事件。1例有主要心血管危险因素的患者在左乳再放疗后13个月死于心肌梗死。整个队列的2年局部区域无复发生存率（LRFS）、总生存率（OS）、疾病特异性生存率（DSS）、无进展生存率（PFS）和远处无转移生存率（MFS）分别为59%、79%、82%、46%和75%。接受根治性或姑息性治疗的患者之间，2年LRFS（72%对31%，P = 0.02）、OS（94%对50%，P < 0.01）、DSS（94%对56%，P < 0.01）和PFS（61%对20%，P = 0.02）有显著差异，但MFS无显著差异（78%对69%，P = 0.77）。在这些患者中，8例（29%）在再放疗后5年无复发。
乳房/胸壁再放疗似乎是可行的，疾病控制良好，尤其是在接受根治性治疗的患者中，且毒性率可接受。
